Timely patient discharge from a large acute care hospital: sharing accountability
SubjectAccountability; Burnaby Hospital; Fraser Health; Shared Decision Making; Timely Discharge; Triple Aim
At Burnaby Hospital (BUH), delay in discharge of patients has widespread impacts on quality, safety, satisfaction, and outcomes. The call for increased accountability for timely discharge at BUH presented the opportunity to review the current model of accountability and to determine if a different model could potentially improve health, experience, and financial outcomes. This research explored the components of responsibility, answerability, trustworthiness, and liability and the requirements for implementing a model of shared accountability. The findings led to recommendations for enhancing shared accountability in the context of discharge planning. A mixed-method action research approach was used, consisting of an online survey and a structured interview matrix. Four recommendations resulted: define and emphasize the value of common goals ; include patients, families, and providers in discharge decision making processes; support providers through focusing on educational, role development, and team development needs; and address liability concerns with forums for increasing organizational learning.
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